chop it off or chop it up?

ImoImo DarwinMember Posts: 16
Hi all, 
I was diagnosed a week ago - Grade 3 IDC in my right breast.  I'm 39.  There are actually two lumps but one is currently classified as 'suspicious' while the other is cancer.  I am gradually coming out of the shock and grieving process of diagnosis (2 days of bawling and grieving my own death) and am now trying to decide what the best surgery option is for me.  At diagnosis my surgeon recommended mastectomy with expander for reconstruction and that still seems to be the simplest option. The sensible option is mastectomy but I'm struggling to come to terms with losing my breast and my nipple, as I'm sure everyone does. It seems so vain of me, and obviously the end game is always survival but, until last Wednesday, not only was that breast part of my identity as a women, and a great dress filler, it had also provided sustenance and comfort to my 21 month old son.  

My surgeon has offered me three options: 
-lumpectomy using therapeutic breast lift and reduction (to fill the hole - the lumps are near the top section) + radiation 
-chemo prior to surgery to reduce size then lumpectomy as above

I'd really value your opinions and experience in both mastectomies and lumpectomies. What do you recommend? 


  • Molly001Molly001 Member Posts: 372
    Hi @Imo you are not bain, just human!  It's tough making these choices. The consequences are so damn permanent! I'm also 39 and I had a right mastectomy followed by chemo then radiotherapy. I'm now on anti-hormone tamoxifen and palbociclib drugs as a preventative. I had basically no choices as my tumor was multi-focal, spread throughout the breast, and very large. Even with a full mx I didn't get clear margins, thus the radiotherapy. I was glad to get rid of the thing that had betrayed me. I had no recon at the time as my team wanted to focus on getting it gone first. I must say I absolutely hate being one-breasted. I will either get a recon or left mx down the track. I'm not too fussed about going flat. I had a great set in my 20s and early 30s but bfeeding my 2 bubbas sucked the meat right out of 'em anyway lol! They've done their job. I know it's common for women to get pathology results after a lumpectomy that require them to have further tissue removed or a mx anyway, but many also have great success with lumpectomy and rads. Given that your tumor is possibly multi and fast growing is a lumpectomy your best option? If your surgeon is recommending a mastectomy, give this option some serious thought. You don't need regrets. You will certainly grieve your beautiful breast but they can do some amazing recons. I hope you can come to a comfortable decision.
  • ImoImo DarwinMember Posts: 16
    Thanks so much for the reply Molly001, 
    I love your breastfeeding comment.  Since weaning my son 2 weeks ago my boobs are slowly deflating like leaky balloons.  I'm starting to think that there won't be much left for the surgeon to work with anyway! As I become slowly more accustomed to my diagnosis it's becoming easier to look more objectively at my options and less emotionally at my breast.  I've decided on a mastectomy, hopefully with expander, and feel very confident about it (except at night after a glass of wine).  
    Now I just want to get on with it! All of the uncertainty that comes with the early stage of diagnosis is driving me crazy.   
  • Sunshine0206Sunshine0206 Member Posts: 120
    edited November 2017
    Hi there,

    well this is take two!

    I am also like you IDC grade 3 but I’m a lefty. Right breast was disease free. I’m 41. Dx at 40. I have a 5 year old. 

    I elected to have a double mastectomy with a node clearance on left. I didn’t think I could manage the anxiety of having the remaining breast intact. The surgery was fine. Minimal pain. Panadol was sufficient. I now have full range of movement and touch wood, no lymphedema.

    I’m now half way through chemo. Will follow up with rad.

    i do understand wanting to get on with it! The waiting is awful! Once treatment starts you will feel more empowered and capable.  Don’t get me wrong, I have shit days but they are less frequent.  I have engaged with a therapist which has been very helpful. 

    What date is surgery?


  • Sunshine0206Sunshine0206 Member Posts: 120
    Good grief. I wrote a huge paragraph and posted. It’s disappeared!
  • SalpalSalpal Member Posts: 30
    I have just had a lumpectomy with 4 nodes removed and nipple repositioned to sit front and centre. My pathology came back with clear margin, 7 cm removed from side of right breast. Unfortunately my 4 nodes were positive for cancer cells. My surgeon and l have discussed and agreed l will have chemo first and then after rounds finished l will have an Auxillary node removal followed by Rads and then Tamoxifen. He advised this for 2 reasons. He doesn't want to delay chemo and gives me more time to consider if l keep my breast or remove.
    He doesn't feel a mastectomy is necessary but will support my decision.
    The funny thing now is my right breast is sitting all nice and perky and my healthy breast not so much...go figure 
    At the end of the day you have to trust your gut xx
  • ImoImo DarwinMember Posts: 16
    Hi Sunshine0206, 

    I met with my oncologist for the first time yesterday, by which stage I was (and still am) very confident with my decision to have a mastectomy.  However, the surgery itself will now come after neoadjuvant chemo.  Going the less common route of chemo prior to surgery means we can *hopefully* confirm the chemo is doing its job. My tumour is triple negative (will the bad news ever stop?!) so I have no hormone therapy to fall back on.  Neoadjuvant chemo also gives the genetics testing time to come back.  BRCA positive will mean a bilateral mastectomy. I'd rather the mastectomy be one surgery instead of right breast now, left breast later. But quite frankly, like you, BRCA gene or no BRCA gene, I don't want the anxiety of cancer turning up in my healthy breast later on.    

    So I get to keep my boobs just a little bit longer (my toddler will be thrilled, he's more attached to them than I am!). 

    My chemo starts on Wednesday.  I'm so much calmer now that I have a treatment plan and a way forward. 

    Still, it's is very disconcerting having two tumours kicking around in there for 6 more months but if the chemo works - yay, I know it's also working on any invisible microtumours too. If the chemo doesn't work.......once I pick myself up off the floor and out of my puddle of tears, we can look at post operative chemo. 

    Thank you Salpal for telling me to trust my gut.  You are completely right, I just needed to do A LOT of research before I knew what my gut instinct was!

    That's great news about your clear margins and perky outcome but it's sad news about your nodes.  Good luck with your chemo.  
  • sangeetamosangeetamo Member Posts: 7
    hi all
    I have just been diagnosed with triple neg BC, but still ruling out the metastatic. being Christmas and new year period- my treatment plan and doctors are still not set properly
    I am dying in this waiting game. can anyone tell me how long does it take from diagnosis to treatment plan to start
  • CrustyCrusty QldMember Posts: 28
    Im also about to start chemo and have a masectomy in 6 months with recon i originally had lumpectomy 3 wks ago had a 2.5cm invasive cancer but still have dcis on all margins im 41 with 5 kids my youngest is 3 
  • SpillsySpillsy Hobart Member Posts: 41
    Hi , I was diagnosed week before Christmas, large lump 5cm couldn't really feel it as a lump, thought nothing of it, just thought my boobs we're changing as I get older,  then visit to drs stared my cancer journey.
    so chemo first, then surgery, but probable looking  at mastectomy, unless we get some shrinkage. Had chemo last week, and it does feel strange to have cancer still in my breast, but chemo hopefully will kill those cells floating around my nodes! At 45 called middle aged by most doctors, but for breast cancer we get the ' young ' description, aren't we lucky!! I had mammograms every two years since 40! So this one decided to grow in between, sneaky! 
  • Lisa JanelleLisa Janelle Member Posts: 42
    I am 46 I thought I was young but I guess I am middle age I am waiting for a mastectomy high DCIS doctors r away so I have been waiting now 3 weeks. Still another 2 weeks before my appointment pretty sad no support at breast screent they  just tell you the result than see you later. 
  • ImoImo DarwinMember Posts: 16
    It's nerve wracking waiting for treatment to start.  Everything I've read says that a few weeks between diagnosis and treatment won't make any difference to long term prognosis (and as my surgeon rather unhelpfully told me - "the tumours have probably been there for 18 months already")  but it's a really hard wait.  I was practically euphoric to start treatment and have my body pumped full of chemicals. 

    To be diagnosed just before Christmas is just awful in so many ways but the salt in the wound is the abandonment of support and care while everyone buggers off on holidays.   I'm certainly not saying they shouldn't, if any industry is going to remind its employees to celebrate time with family its oncology and all of its support services. So thankful for BCNA online support!  
  • SpillsySpillsy Hobart Member Posts: 41
    agree, bummer of a Christmas and new year!!! I have started chemo last week, and was glad to be doing something, still a bit scared of having a cancer inside me, still bubbling away, but it was faster to start my chemo 29th Dec, so I am one round in. I must admit I haven't really told many people as I didn't really know how to say, oh happy new year and by the way I have BC, conversation stopper!!! I reckon when my hair starts falling out people might guess!!!! we must be commencing this shitty journey at the same time!!! Good luck
  • ImoImo DarwinMember Posts: 16
    Hi Spillsy,

    I had my fifth round today, I'm having it weekly so i'm only a month in, still early days for me too.  I'm already glad I made the decision to go with chemo first rather than surgery as I can no longer feel the lump. So I feel reassured that the chemo is working (like it sounds with you in your message- not so much worried about the lump, just any little travelling bastards that might be getting about looking for a new home in my organs).  I'm wary of celebrating that though as I know there are so many unknowns in this journey that i don't want to jinx anything by having the audacity to feel optimistic. 

    Telling people is a weird conversation to have, especially those times when friends I haven't seen in a few months so happily and casually ask what I'm up to.  So there I am at the supermarket, at a Christmas do, at a playdate surrounded by joyous laughing toddlers, explaining to shocked friends how the last month has unfolded.....  I guess I unconsciously made the decision to let people know when the opportunity arose rather than anything more formal like calling people (other than close friends and family).  So some poor buggers have been dealt my bad news when they thought they were just popping out for icecream and happen to run into me! 

    But it's not really a conversation stopper, more of a starter and I've been blown away by the tenderness and love from my friends. Hopefully you will be too.

    There's a great neo-adjuvant decision guide that is linked through the BCNA webpage on neo-adjuvant chemo. Have you seen it?  It was really useful for me when i was making the decision about chemo or surgery first.  Although your decision is made, it could still help you feel better about getting through the next few months with the tumours still there.  

    Good luck and HAPPY NEW YEAR!! ;-) 
  • Sunshine0206Sunshine0206 Member Posts: 120
    edited January 6
    So nice to know I’m not the only “younger” woman floating around on this network. Thanks ladies. 

    Thinking of those of you in the holding pattern of new dx. Xx

    And those just starting treatment. Xx

    I’m up to week 8 /12 of taxol next Friday. Then hopefully I’m done for several years. 
    Ac is done. 

  • Sunshine0206Sunshine0206 Member Posts: 120
    @Imo - who is your surgeon in darvegas? I worked at Rdh for nearly 10 years...
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